An examination of the New Jersey's Northern Regional Medical Examiner's Office in Newark found a number of deficiencies, including the lack of accreditation for the state's toxicology laboratory.

By KEVIN C. SHELLY | For INSIDE JERSEY magazine

POSTMORTEM

The New Jersey Office of the Medical Examiner finds itself in the crosshairs following its autopsy report on the deaths of Cooper Health System CEO John Sheridan and his wife, Joyce. Find the story here and in the July issue of Inside Jersey magazine.

THE NATIONAL ASSOCIATION of Medical Examiners denied reaccreditation to New Jersey's Northern Regional Medical Examiner's Office last year because of deficiencies it found in 10 areas of operation, six of which were considered serious violations.

Documents released by the state Attorney General's office, requested under the Open Public Records Act, show that during NAME's on-site inspection in 2013, the NRMEO failed in six serious categories, known as Phase 2, and in four lesser areas, called Phase 1. Although accreditation is not mandatory, the NRMEO has not been credentialed since its designation lapsed in 2011.

The most troubling failure, according to the on-scene investigator's report, was the fact that the state's toxicology laboratory is unaccredited by the College of American Pathologists. All of the lab's certifications lapsed in 2009, according to CAP spokeswoman Julie Monzo. Yet, the state's website says the lab "received accreditation in forensic urine drug testing by the College of American Pathologists in 2005," without noting that the designation has since lapsed.

Also, a search of the American Board of Forensic Toxicology database does not show certification for the lab to conduct toxicological testing. Calls to the board were not returned.

The lab, which shares space with the NRMEO, provides toxicology reports for every medical examiner's office in the state. It operates under the jurisdiction of the Division of Criminal Justice.

"A medical examiner's office depends on a toxicology laboratory for analysis of body fluids and tissues for drugs and chemicals," said Marcus Nashelsky, president of NAME. "This analysis is often a fundamental component (of a case).

"Accreditation is formal recognition of a high level of operational and personnel excellence," he added, noting, however, that "a lack of accreditation does not necessarily mean that a laboratory performs suboptimal work."

Zach Hosseini, a spokesman for the state Attorney General's office and the Medical Examiner's office, said the toxicology lab did not meet CAP recertification standards because it employs too few personnel, given the work volume.

David Fowler, chairman of the NAME accreditation committee, outlined the reasons for the NRMEO's failure in a March 2014 letter to Lauren Thoma, who, at the time, was the top pathologist at the NRMEO. She is now assistant medical examiner in Middlesex County.

The most serious deficiencies found by Dennis J. Wickham, a medical examiner from Washington state who served as the on-site inspector, were:

• The state toxicology lab is unaccredited.

• There is no written policy for identifying cases that require on-scene investigators.

• Body transport vehicles are not kept clean.

• Paraffin blocks, used to prop up bodies during examination, are stored in a room that can reach temperatures as high as 85 degrees.

• The facility does not have a policy for completing unfinished cases.

• The office fails to complete 90 percent of postmortem exams within 90 days. The office completed only 49 percent within 90 days as of May 2013.

Less serious failings noted in the review were:

• Foul odors.

• Porous surfaces that cannot be cleaned.

• Failing to complete 90 percent of all postmortem reports within 60 days of the autopsy.

• Not all medical examiners are board certified.

Wickham also wrote that it appeared the office was ill prepared, saying, "a thorough self-inspection utilizing the checklist did not occur prior to the request for inspection."

He also noted he had to spend a "considerable amount of time" coaching the NRMEO to address questions raised by the checklist, which is sent out in advance of the scene visit.

Hosseini, the AG's spokesman, had previously said the northern office had failed because too many autopsies are assigned per doctor. And he noted that seeking accreditation is voluntary, not required.

This week, Hosseini responded to the release of additional details regarding the office's failure by reiterating that accreditation is not mandated.

"Our department views many of the standards for NAME accreditation to be guideposts for the efficient and professional maintaining of our regional and county medical examiner offices," he said. "Since the Northern Regional Medical Examiner's Office last attempt to gain accreditation, we have addressed many of the points NAME said fell short of those suggested guideposts."

Issues with the state Medical Examiner's office came to light following the September 2014 autopsies of John Sheridan, CEO of Cooper Health System in Camden, and his wife, Joyce. One of their sons, Mark Sheridan, on behalf of the family, is challenging the state's findings that his father killed his mother and then committed suicide.

The disarray in the NRMEO and the state's overall medical examiner system, which is explored in "Postmortem," a story in the July issue of Inside Jersey magazine, largely begins with the absence of a top state medical examiner.

The state medical examiner oversees the NRMEO, and the Southern Regional Medical Examiner's Office (SRMEO), and coordinates and supervises all of the county medical examiner offices.

Last week, Gov. Chris Christie announced he had nominated Andrew L. Falzon, a former medical examiner in Middlesex and Monmouth counties, to serve as the state's top ME. The post has remained vacant since Victor Weedn, acting chief medical examiner, resigned in 2009, citing serious problems with the state's ME system.
Falzon is a native of Malta, an island country located between Sicily and North Africa. He attended the University of Malta and is board certified in pathology. Falzon could not be reached for comment.

His appointment will depend on approval by the state Senate, beginning with the judiciary committee. With a summer legislative recess looming, his consideration likely will not happen until fall. State Sen. Joseph F. Vitale, a Democrat from Woodbridge who has repeatedly attempted to reform the state ME system, did not respond to repeated calls for comment.

CORRECTION (June 29, 2015): An earlier version of this story misstated the office that oversees the toxicology lab of the Northern Regional Medical Examiner's Office in Newark. The lab reports to the Division of Criminal Justice.